Posts Tagged ‘cancer treatment’

Treatment for Multiple Myeloma at Emory – Real Patient Story

myeloma_mooney_coverCathy Mooney shares her multiple myeloma patient story. Treatment for multiple myeloma is the topic very relevant to even those who consider themselves a “health nut” or a “gym rat”. This article shares a story of how one health-conscious young lady had to undergo a treatment for multiple myeloma at Emory.

Cathy Mooney didn’t need a wake-up call. In 2002, at 48 years old, “I felt like I was at the top of my game,” she says. “I was exercising regularly, walking four miles five days a week. I was following a great diet. I had really never been in better health.” But a routine physical exam turned up some troubling results, and a long series of visits to specialists and tests followed. After a frustrating three months, Mooney heard two words she never knew before: multiple myeloma.

“I learned that the survival rate was three to five years,” she says. “We were devastated. I felt wonderful; I did not feel sick.” Mooney received an advise to travel from her home in Thomasville, Georgia, to Little Rock, Arkansas. There was a center specializing in myeloma.

For several years she received the following treatment there:

  • chemotherapy
  • autologous stem cell transplantation
  • maintenance medications

Although her cancer could be coaxed into remission, it kept coming back.

In 2008, Mooney and her husband flew north to visit myeloma specialists at Sloan Kettering and the Dana-Farber Cancer Institute. The latter was Ken Anderson, who had been following Lonial’s progress at Winship. Both told Mooney that she could get the best, most current treatment in her home state of Georgia.

“When we went to Emory and met with Dr. Lonial and his team, we found him to be a compassionate person who cared and was passionate about finding a cure for multiple myeloma,” Mooney says. “He’s such a respected doctor in this field, one of the top in leading research and a rising star.”

Since Mooney’s diagnosis, her twin daughter and son have married and had children of their own. Her five grandchildren are a constant delight.

“This year was 14 years since my diagnosis, which is a lot more than I hoped for,” she says. “I’m feeling great. The cancer has given me an opportunity to reassess my life and set new priorities. And Winship gives me hope for a bright future.”

Multiple Myeloma Symptoms & Treatment – Real Patient Story

Meet Emory's real Multiple myeloma patient and learn about Multiple myeloma symptoms and treatment optionsMultiple myeloma begins in the bone marrow with plasma cells going haywire. This article shares a multiple myeloma patient story, as well as discusses symptoms and treatment options.
Seven years ago, Tamara Mobley was so busy, active, and energetic that if she were a cartoon, she’d be a blur. The dedicated mother of two young boys, a loving wife and a full-time employee in a good job, she didn’t get much downtime.

“I think I was just busy, like any other typical mom,” Mobley says. “You know, just doing things to take care of the house, my family and doing my best to be a valued employee. That was my life before, just ripping and running.”

Then Mobley, who was 33, got tired. Not just garden-variety, too-little-sleep, I’ve-been-doing-too-much sort of tired. But bone tired, from the moment she woke up each morning. Then, there was the severe back pain. And then, the passing out. She was getting sick and it was happening fast. For a young, vibrant, working wife and mother that was terrifying.

A trip to the emergency room led to a rapid diagnosis of multiple myeloma — a cancer of the blood — and a recommendation from her doctor to seek treatment at Emory and Winship.
Mobley was so ill that she got to Emory University Hospital in an ambulance. And that’s when all the ripping and running slowed way, way down — at least for a while.

Multiple Myeloma Symptoms

As cancer goes, multiple myeloma is a bit of a misfit.

For one thing, it’s rare. The American Cancer Society estimates that about 30,000 new cases of myeloma will be diagnosed this year, trailing far behind the most common cancers — breast and lung — each of which will derail more than 220,000 lives. That’s stiff competition for research funding and awareness.

For another, it’s mysterious. Multiple myeloma begins in the bone marrow with plasma cells going haywire. But experts aren’t entirely sure how the process starts or what the key risk factors are. The disease is most common in people over 65, men are slightly more vulnerable and that African Americans are more than twice as likely as white Americans to get it. But we don’t know why.
The most notable differ
ence between multiple myeloma and pretty much all other types of cancer is that the life expectancy for myeloma patients has doubled in the past decade. All thanks to treatments developed and tested at Emory’s Winship Cancer Institute.

Multiple Myeloma Treatment

Last November, the US Food and Drug Administration (FDA) approved the fourth new myeloma drug to be green-lighted within one year —three of those within one monthv—and all four were tested in clinical trials at Winship.

“There’s no other story like that in cancer,” says Sagar Lonial, Winship’s chief medical officer and chair of the Department of Hematology and Medical Oncology in the School of Medicine.
Since his arrival at Emory and Winship in 1997, Lonial has built the multiple myeloma program into one of the best and most sought-after in the country. A team of experts who specialize in the disease leads this program. As Georgia’s only National Cancer Institute–designated cancer center and one of just 69 in the US, Winship offers patients the chance to be treated in the same building where research is taking place. There are three floors dedicated to basic science and three to clinical care.

“That marriage of research and patient care is powerful,” Lonial says. “Our scientists see cancer patients every day.”

One of those is Mobley, who has been in treatment at Winship since that devastating ambulance ride in 2009. Once her condition was stabilized, she began the standard protocol. It consists of a three-pronged attack:

  • Chemotherapy to blast away the cancerous cells
  • Stem cell harvesting and transplantation to regenerate healthy bone marrow cells
  • Regimen of medications calibrated to keep the cancer at bay and send it into remission for a long time.

It’s that last phase that has put Winship’s approach ahead of other myeloma treatment centers. Instead of a one-by-one, trial-and-error approach to drug therapy, Lonial has advocated a full court press. It allowed to hit the residual cancer with a simultaneous three-drug combination.

Mobley was put on an aggressive course of therapy made up of

  • Lenolidamide (Revlimid), an immune modulator
  • Bortezomib (Velcade), a proteasome inhibitor
  • Dexamethasone, a corticosteroid

“That concept of combination therapy is one that our center is focused on and one that benefited her early on,” Lonial says.

According to myeloma researcher Lawrence Boise, Georgia Cancer Coalition Distinguished Cancer Scholar and coleader of the Cancer Cell Biology Program at Winship, scientists are finding that there are many reasons for this. But the most compelling is that it works. “Dr. Lonial doesn’t leave any bullets in the chamber,” Boise says. “In all the trials, all the data, all the comparisons show that three drugs are better than two.”

When Lonial joined Emory’s hematology and oncology department nearly two decades ago, other researchers might have seen a department struggling with turnover and inadequate resources. With the encouragement of a mentor—Kenneth Anderson, probably the best-known myeloma specialist in the world—Lonial saw an opportunity to build a program, from the ground up.

The bottom floor of Winship houses the Clinical Trials Unit, the key to the multiple myeloma program’s growth and success. Within a few years, Lonial had recruited top scientists and clinicians, including Boise, and was testing new classes of drugs in Phase I clinical trials. They proved to be game changers.

Multiple myeloma is a cancer of the blood that develops when normal, antibody-producing plasma cells become malignant and their growth spirals out of control. They build up in the bone marrow until they crowd out healthy blood cells. They can form lesions and tumors in multiple bones, hence the condition’s name.

But the cancerous cells also secrete protein and, like normal cells, they’re engineered to do this in a particular way—the protein assembled and folded just so. When that assembly goes awry, as it does in myeloma cells, the malformed proteins are broken down by proteasomes—protein complexes whose job it is to get rid of problem proteins by degrading them—and that opens up the pipeline for more myeloma cell production.

About ten years ago, scientists discovered that if you interfere with the proteasome’s work—allowing the abnormal proteins to accumulate—the cancerous cells, which in a sense are trying to function normally, will self-destruct. Rapidly.

“Proteasome is part of quality control, so if you inhibit that, and all these mid-folded proteins build up, that causes stress, and the cell kills itself,” Boise explains.

Winship conducted trials of a promising proteasome inhibitor, bortezomib (Velcade), in 2002. One of the first patients to receive it went into remission quickly. “If there was a moment when the light went on, it was then. I remember running upstairs to the director’s office with the graph of this patient’s counts,” Lonial says. “That treatment is now the standard of care.”

Learn more about Tamara’s story here.

What is High Dose Rate Brachytherapy?

One of the most technically advanced and convenient options for cancer treatment is called high dose rate brachytherapy (HDR). It is a precise type of radiation therapy that is commonly used to treat localized gynecologic, lung, breast and prostate cancers that have not spread to lymph nodes. As opposed to low dose rate (LDR) brachytherapy, where tiny radioactive “seeds” are permanently placed inside or near a tumor, HDR brachytherapy involves temporarily placing high intensity sources of radiation inside the body with a catheter, for example, and then removing them once treatment is complete.

With short treatment and recovery times, HDR brachytherapy can help patients get back to their lives with minimal disruption. At Winship Cancer Institute of Emory University, the therapy is usually performed on an outpatient basis and carried out in two short sessions over one to two weeks. This results in an extremely precise radiation dose and minimal toxicity to the patient. Patients considering HDR brachytherapy may wonder if they will be radioactive following treatment. The answer is no. The radiation flows like the light that shines from a flashlight; it is not present once the treatment session is completed and the device used to deliver the radiation is removed.

HDR brachytherapy is performed at Winship locations by knowledgeable radiation oncologists with special expertise and certification in brachytherapy. The Department of Radiation Oncology at Winship is the only program in Georgia with advanced credentialing recognized by the National Cancer Institute for both LDR and HDR brachytherapy administration and expert usage.

Watch the short video below to learn more about how HDR brachytherapy is used to treat prostate cancer.

Find a Doctor

HDR Brachytherapy is performed at Winship locations by the following physicians:

For more information regarding HDR brachytherapy treatment at Winship Cancer Institute, please visit Emory Radiation Oncology.

In addition to regular treatments, a voluntary research study is being conducted to help men with recurring prostate cancer by using advanced imaging technology called FACBC to guide radiotherapy and determine the best possible course of treatment. Read more>>

About Dr. Rossi

Peter Rossi, MDPeter Rossi, MD, is a board certified radiation oncologist and the Medical Director of Radiation Oncology at Winship at Emory St. Joseph’s Hospital. Dr. Rossi specializes in the treatment of prostate cancer, cervical cancer and ovarian cancer, and his expertise is in the use of external radiation therapy and brachytherapy for treating prostate and gynecologic tumors. Dr. Rossi is on the Quality Assurance Committee of the American Brachytherapy Society. He lectures, proctors and mentors physicians on the use of HDR brachytherapy for the treatment of prostate cancer at Winship and internationally.

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What is Radiation Therapy and How is it Used to Treat Cancer?

Radiation therapy is a type of cancer treatment that is used to shrink tumors and stop the growth of cancer cells. High energy x-rays are aimed directly at cancerous cells or tumors. According to the American Society for Radiation Oncology (ASTRO), the technique is so effective in treating many different types of cancer that nearly two-thirds of all cancer patients will receive radiation therapy at some time during the course of their cancer treatment.

Depending on the type of cancer being treated, radiation may be used as a stand-alone treatment and often it is the only treatment needed. Or, it may be used in combination with surgery, chemotherapy and/or other targeted therapies. For example, doctors may use radiation therapy to shrink a tumor before surgery, or after surgery to stop the growth of any cancer cells that may be left behind.

Watch the video below to learn about the types of radiation treatments available to patients at Winship Cancer Institute:

Visit the new mobile-friendly Emory Radiation Oncology website to learn more about treatments and services offered in the Department of Radiation Oncology and what to expect as a new patient.

About Dr. Godette

Karen Godette, MDKaren Godette, MD, is a board certified radiation oncologist in the Department of Radiation Oncology at Emory University School of Medicine. Dr. Godette practices general radiation oncology and specializes in breast and gynecological malignancies, prostate cancer and soft tissue sarcoma. Within these areas, her expertise is brachytherapy. Dr. Godette treats patients at Winship at Emory University Hospital Midtown where she has served as medical director since 2001.

Working During Cancer Treatment

Working with CancerTo work, or not to work, during cancer treatment is often a very real decision that patients must make. Some patients need to continue working during treatment for financial support, or to keep their insurance coverage, or just an overall desire to continue working. Working during treatment can be difficult depending on the type of treatment a patient receives, but also on the type of work a patient does. For example, a patient who can work from home may be able to continuing working whereas a patient with a job that requires more physical demands may be unable to continue working. Here are a few things to remember when working during cancer treatment:

  • Discuss your job situation with your medical team. It is important for your medical team to be aware of your desire or need to work during treatment. This may help in determining a treatment schedule that works best for you in order to continue working. Also, discussing the type of work you do with your medical team will allow them to provide you with appropriate information about how your treatment may affect your ability to perform the duties of your job.
  • Depending on your level of comfort, talk with your employer or human resource department about your diagnosis and treatment schedule. This will allow you to discuss any accommodations you may need in order to complete your job tasks. This is also an opportunity to discuss the possibility of working from home.
  • Consider utilizing the Family Medical Leave Act, if you are eligible. This important legislation was put in place in order to protect patients when they must leave work in order to receive medical care. Consult your human resources department for additional guidance in determining if you are covered through this.
  • Consult your human resource department regarding possible short-term or long-term disability benefits you may have available. There may be times in which patients are unable to work due to lengthy hospitalizations or because their medical team advises against it. In instances such as these, you may consider utilizing your short-term and long-term disability benefits in order to continue receiving some income.
  • If you are comfortable, talk with your coworkers about your diagnosis and treatment. Coworkers can be a strong source of support and encouragement during these difficult times. This may also help in developing a work schedule that works for you during treatment.
  • Talk with the social worker at your oncology office. Social workers may be able to help problem solve any concerns or issues you may be having with your employer.

Although working during cancer treatment may be challenging, it does not have to be impossible. Just talking with others about this may help you get the assistance you need.

About Joy McCall, LCSW

Joy McCallJoy McCall is a Winship social worker with bone marrow transplant, hematology and gynecologic teams and their patients. She started her professional career at Winship as an intern, working with breast, gynecologic, brain and melanoma cancer patients. She graduated with a Bachelor of Science in Psychology from Kennesaw State University and a Master of Social Work from the University of Georgia. As part of her education she completed an internship with the Marcus Institute working on the pediatric feeding unit, and an internship counseling individuals and couples at Families First, supporting families and children facing challenges to build strong family bonds and stability for their future. She had previously worked with individuals with developmental disabilities for over 4 years, providing support to families and caregivers.

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Fundamental Science Can Transform Cancer Care Worldwide

World Cancer Day is February 4, and it is an important reminder that cancer is one of the leading causes of death worldwide. According to the World Health Organization, the number of new cases is expected to rise by about 70% in the next two decades. This gives us all the more reason to recognize the progress that has been made because of discoveries by fundamental, or basic, cancer researchers. Our task now is to bring the benefits of that work to patients around the world. Check out this short video where Fadlo R. Khuri, MD, Deputy Director of Winship Cancer Institute discusses these discoveries in fundamental cancer research:

The theme of this year’s World Cancer Day, “Not Beyond Us,” highlights solutions that are within our reach. In that spirit, we celebrate 2014 as a landmark year for cancer research, discovery, treatment and prevention. Important progress was made in a number of areas: screening and prevention of cancers, development of novel targeted therapies for cancers, and immunotherapy of a number of previously resistant diseases. Over the past year, we saw at least a half dozen new approvals by the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) of new, improved, potent targeted therapies, chemotherapies, and immunotherapies for cancer, whose impact is most acutely felt in societies in North America, Europe, Eastern Asia, Australia and South America. Our therapeutic resources have been significantly advanced by these discoveries, all of which spring from major biologic breakthroughs in the laboratory. What should the next steps be in ensuring that the powerful tools of genomic medicine, immunology, and molecular imaging continue to flourish and impact cancer patients worldwide? How do we make sure that personalized, precision medicine can be practiced to benefit oncology patients globally?

Fundamental to progress in cancer diagnosis, treatment and prevention is continued investment in fundamental cancer research. In a decade in which the growth of real federal funding for basic and translational research in cancer has slowed noticeably in the United States, this challenge has been counterbalanced on some levels by substantial increases in investment in basic and translational research in Asia (China and India in particular), Europe (Germany and Great Britain in particular), and Australia. Nonetheless, research conducted in United States laboratories remains the major driver of cancer discovery in the areas of genomics, immunology, and prevention, and in the translation of these discoveries from the bench to the bedside, aided by accelerated developments in the biotech and pharmaceutical world. On-going support for researchers in the fundamental sciences will ensure that these new discoveries will continue to substantially enhance our therapeutic and preventive arsenal against cancer. Fundamental science is vital to the global war against cancer.

As discoveries accelerate, and increasing numbers of affordable new treatment modalities are brought into the clinic, making an impact on diseases from Africa and Australia, through Asia and Europe, and all the way to the Americas, we must continue to support, guard, and mentor our treasure trove of outstanding scientists and clinical investigators. Over the next several decades, these individuals will be the key to sustaining and accelerating the major advances that are being made against cancer. Discoveries in the labs of outstanding scientists in basic immunology, genomics, glycomics and metabolomics, and in understanding the biologic behavior of normal, pre-malignant, and cancerous cells, pave the way for clinical translations that improve the prevention and therapy of our global population as a whole.

About Dr. Khuri

Fadlo Khuri, MDFadlo R. Khuri, MD, deputy director of the Winship Cancer Institute of Emory University, professor and chairman of the Department of Hematology & Medical Oncology, Emory University School of Medicine, and executive associate dean for research of Emory University, is a leading researcher and physician in the treatment of lung and head and neck cancers. He is Editor-in-Chief of the American Cancer Society’s peer-reviewed journal, Cancer.

Dr. Khuri’s contributions have been recognized by a number of national awards, including the prestigious 2013 Richard and Hinda Rosenthal Memorial Award, given to an outstanding cancer researcher by the American Association for Cancer Research.

An accomplished molecular oncologist and translational thought leader, Dr. Khuri has conducted seminal research on oncolytic viral therapy, developed molecular-targeted therapeutic approaches for lung and head and neck tumors combining signal transduction inhibitors with chemotherapy, and has led major chemoprevention efforts in lung and head and neck cancers. Dr. Khuri’s clinical interests include thoracic and head and neck oncology. His research interests include development of molecular, prognostic, therapeutic, and chemopreventive approaches to improve the standard of care for patients with tobacco related cancers. His laboratory is investigating the mechanism of action of signal transduction inhibitors in lung and aerodigestive track cancers.

Easing the Tension of Traveling for Cancer Treatment

Travel for TreatmentAs a social worker at Winship Cancer Institute of Emory University, I see many patients who travel from out of the state and the country in order to receive medical care. Their cancer treatment can sometimes be scheduled every day for six weeks or more. This can add a lot of stress to an already difficult situation.

It can be daunting to arrange all the transportation and lodging logistics, especially for an extended period of time. Patients and caregivers are also faced with being away from the comforts of their own home and support of loved ones who may live close by. Here are a few tips to consider if you have to travel for treatment:

  1. Contact your medical insurance company regarding travel benefits. Some insurers will provide transportation and lodging benefits in the form of reimbursements if patients must receive treatment a great distance from their home.
  2. Discuss hardships with your medical team. Make sure that your doctor and nurse navigator are aware of any financial hardship you are going through in order to get treatment. Some patients may be able to receive their therapy closer to home at a local infusion or radiation center. They can still continue to be followed by their preferred physician who is out of town.
  3. Reach out to loved ones for support. Many family members and friends may be unsure of how to help when a patient is undergoing treatment, however, they are longing to be able to provide some sort of assistance. Don’t be reluctant to request help with transportation or other needs.
  4. Consider holding a community fundraiser. Many families underestimate the cost of medical care and all that comes with it. Reality can hit when they are fully involved in the treatment process. Fundraisers are a great way to reach out to community members and request assistance. This assistance can then be used to help cover the extra expenses of transportation to a treatment facility or lodging away from home.
  5. Reach out to a social worker at the clinic where you or your family member receives treatment. There may be additional resources or discounts through community agencies that offer further support when a patient or family must travel

Finally, if you have to stay at a hotel during medical treatment, be sure to bring along some special items that will remind you of home. Photos, a cozy blanket and a favorite sweatshirt can help make home feel a whole lot closer. Click to learn more about available resources at Winship for our patients and families.

About Joy McCall, LCSW

Joy McCallJoy McCall is a Winship social worker with bone marrow transplant, hematology and gynecologic teams and their patients. She started her professional career at Winship as an intern, working with breast, gynecologic, brain and melanoma cancer patients. She graduated with a Bachelor of Science in Psychology from Kennesaw State University and a Master of Social Work from the University of Georgia. As part of her education she completed an internship with the Marcus Institute working on the pediatric feeding unit, and an internship counseling individuals and couples at Families First, supporting families and children facing challenges to build strong family bonds and stability for their future. She had previously worked with individuals with developmental disabilities for over 4 years, providing support to families and caregivers.

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Getting the Best Cancer Treatments into Outlying Communities

Cancer Treatment in CommunitiesThe purpose of the community outreach program I oversee at Winship Cancer Institute of Emory University is to bring our clinical and population-based research to communities throughout Georgia and surrounding states in order to benefit patients in those areas. By partnering with community oncologists, we can offer our expertise and best practices to help them successfully treat patients with types of cancer that are less common or more difficult to treat.

A great example of this is a program we’ve developed to treat patients with acute promyelocytic leukemia (APL), an uncommon but highly aggressive disease. We actually call it the heart attack of leukemias because a third of the patients do not survive the first month of treatment. We have chemotherapeutic drugs that are very effective in treating APL, but because it is a rare condition, physicians who treat it in the community may not be familiar with the potential complications that patients may develop during treatment.

Yet it is a highly curable disease, and at Winship we have come up with a simple approach that is keeping these patients alive during the first, most crucial month. This method decreases mortality from an estimated 30 percent to less than five percent.

We started by taking a very complicated treatment algorithm and simplifying it to a page and a half, and then used that to develop a three-step process to help community oncologists treat patients quickly and effectively. As soon as we get a call from a community physician, we send the simplified algorithm via smart phone. Then we talk to the physician on the phone and figure out what the patient is going through. Lastly, we give them a treatment plan to get them through the first month and follow up with emails, phone calls or text messages.

We’re grateful that community doctors are receptive to the guidance offered by Winship. By taking swift action, they are giving their APL patients the best chance of survival. It’s extremely gratifying to see people in outlying parts of Georgia and South Carolina receive this treatment protocol and survive this disease.

Watch Dr. Jillella explain the way Winship is helping save patients’ lives following diagnosis of acute promyelocytic leukemia in the video below:

About Dr. Jillella

Anand Jillella, MDAnand Jillella, MD, is a national leader in bone marrow transplantation and has led the development of a strategy to decrease induction mortality for acute promyelocytic leukemia. He leads the efforts of the Winship Cancer Network and is expanding Winship’s role in bringing clinical and population-based cancer research to communities throughout Georgia and surrounding states.

Caring for the Caregiver

Cancer CaregiverCaring for a loved one who has been diagnosed with cancer is such an important role. Most often it is a spouse, family member or close friend who becomes the primary caregiver for the patient. It’s a big responsibility that can, at times, be overwhelming. Sometimes we forget that caregivers need to be taken care of too.

Here are some tips for caring for the caregiver:

  • Reach out to other friends and family members for assistance. Make a list of duties that need to be completed in order to care for the patient. Ask others to help complete those tasks. This can help alleviate some stress for the caregiver.
  • Sign up for a caregiver support group. This can introduce you to other caregivers who are in a similar situation. It is also a great way to share ideas and tips. Winship Cancer Institute has a Caregiver Support Group that meets on the third Wednesday of each month for caregivers of cancer patients. Caregivers may also be interested in reaching out to other caregivers for some one-on-one support.
  • Make sure you are getting enough sleep and rest. Seven to eight hours of sleep each night can help you recharge your body and mind and give you more energy.
  • Consider relaxation techniques like meditation and yoga. Journaling is another great way to help process your feelings. This can be helpful in coping with some of the stress related to caregiving.
  • Don’t neglect your own health. Be sure to schedule and keep your own doctor appointments. It is common for caregivers to put all of their focus on the patient’s needs and ignore their own health. If you are a caregiver, you must take good care of yourself; otherwise, your own health concerns may make you unable to continue taking care of the patient.
  • Make time for yourself. It is important that caregivers do things that they enjoy doing, such as spending time with friends, participating in a hobby or exercising.

It’s easy to burn out while caring for a loved one with a serious medical condition. Pace yourself and know that you have don’t have to go it alone.

About Joy McCall, LMSW

Joy McCallJoy McCall is a Winship social worker with bone marrow transplant, hematology and gynecologic teams and their patients. She started her professional career at Winship as an intern, working with breast, gynecologic, brain and melanoma cancer patients. She graduated with a Bachelor of Science in Psychology from Kennesaw State University and a Master of Social Work from the University of Georgia. As part of her education she completed an internship with the Marcus Institute working on the pediatric feeding unit, and an internship counseling individuals and couples at Families First, supporting families and children facing challenges to build strong family bonds and stability for their future. She had previously worked with individuals with developmental disabilities for over 4 years, providing support to families and caregivers.

Related Resources:

Caregivers of Cancer Patients Need Care Too
Support Groups at the Winship Cancer Institute of Emory University
American Cancer Society
CancerCare

What You Need to Know About Personalized Cancer Care

personal cancer careThe most promising advances in cancer treatment today center around personalized or precision medicine, but what exactly does that mean? We asked Dr. Fadlo Khuri, deputy director of the Winship Cancer Institute of Emory University, to explain the terms and help us understand who is benefitting from these types of treatment.

Q: What is personalized or precision medicine in cancer treatment?

Khuri: The best individualized care plan for every patient is one that delivers the most precise, informed and effective treatment possible. One of the new tools we use today in order to add to the patient’s medical history, social history, and pathologic diagnosis, is modern molecular testing.

Q: What is molecular testing?

Khuri: Molecular testing in cancer is performed on tissue taken during a tumor biopsy. Several tests can be done to reveal the genetic makeup of the mutation present in the cells of a particular cancer, such as non-small cell lung cancer. This genetic mapping, or DNA sequencing, is called genomics.

Q: People are familiar with genetic testing for the BRCA gene mutations that cause ovarian and breast cancers. But how are genomics or genetic targeting used in cancer treatment?

Khuri: Genomics uses modern DNA sequencing methods, recombinant DNA and informatics to study the complete genetic makeup of individual cells, patients, populations and their diseases. We learn how certain gene mutations, such as EGFR or ALK mutations in lung cancer, determine a tumor’s behavior and survival. We use these driver mutations to design treatments that specifically target the protein product of the mutated (or altered) genes. This leads to more targeted treatments based on an individual patient’s cancer.

Q: What is immunotherapy and how is it being used at Winship?

Khuri: Immunotherapy is a type of treatment that stimulates a patient’s own immune system to either work harder overall, or to attack cancer cells specifically. We are exploring immunotherapy at Winship through research and clinical trials. We have a series of clinical trials designed to activate or drive the immune system to recognize the individual’s cancer as foreign to their body, such as vaccines or immune checkpoint inhibitors, to attack the tumor.

Q: Which type of patients benefit from immunotherapy?

Khuri: Patients with leukemia, lymphomas, myeloma, lung cancer, kidney cancer and especially melanoma seem to benefit from immunotherapy. Other diseases are also being studied. Immunotherapies are demonstrating durable (long lasting) responses in a number of the above tumor types, and this has added a powerful new option to the toolbox of targeted therapies of cancer.

Q: What are the advantages and challenges?

Khuri: The advantages include the durability of the responses seen, but the people with cancer who benefit are in the minority so far. Efforts at developing efficient and precise ways to deliver immunotherapy are ongoing.

Q: What is the latest research at Winship that is related to precision medicine?

Khuri: Winship has clinical trials in myeloma, lung cancer, leukemia, lymphoma, breast cancer, colon cancer, thyroid cancer and melanoma which target specific driver mutations and are excellent examples of precision medicine.

Q: How have these approaches changed the way doctors now treat cancer patients?

Khuri: Many centers, like Winship, do reflex testing, which automatically sends a patient’s sample for a molecular screening panel that looks for tumor mutations. Certain gene mutations are known to drive cancer growth, cause drug resistance or susceptibility, or are currently under investigation as therapeutic targets in clinical trials, so the results of those tests can determine the type of treatment a patient receives.

About Dr. Khuri

Fadlo Khuri, MDFadlo R. Khuri, MD, deputy director of the Winship Cancer Institute of Emory University and Professor and Chairman of the Department of Hematology & Medical Oncology, Emory University School of Medicine, is a leading researcher and physician in the treatment of lung and head and neck cancers. He is Editor-in-Chief of the American Cancer Society’s peer-reviewed journal, Cancer.
Dr. Khuri’s contributions have been recognized by a number of national awards, including the prestigious 2013 Richard and Hinda Rosenthal Memorial Award, given to an outstanding cancer researcher by the American Association for Cancer Research.

An accomplished molecular oncologist and translational thought leader, Dr. Khuri has conducted seminal research on oncolytic viral therapy, developed molecular-targeted therapeutic approaches for lung and head and neck tumors combining signal transduction inhibitors with chemotherapy, and has led major chemoprevention efforts in lung and head and neck cancers. Dr. Khuri’s clinical interests include thoracic and head and neck oncology. His research interests include development of molecular, prognostic, therapeutic, and chemopreventive approaches to improve the standard of care for patients with tobacco related cancers. His laboratory is investigating the mechanism of action of signal transduction inhibitors in lung and aerodigestive track cancers.

Related Resources

Genomic Testing for Lung Cancer: What Does it Mean for You?